Table 2 Summary of data on cooling methods based on conduction in the treatment of exertional heatstroke

[18] (Israel, 1967)

Exertional heatstroke

(n = 36)

Case series

Ice-filled rubber bottles over the whole body; cool air-conditioned room; target T_rect: not given

Mortality; morbidity

Mortality: 22.2%; neurologic morbidity: 11.1%

Patients enrolled over 10-year period; no cooling time provided; cooling performed in different centers

[19] (U.S., 1975)

Exertional heatstroke

(n = 15)

Case series

Iced water immersion; target T_rect: 38.8°C

Mortality; morbidity

Mortality: 0%; neurologic morbidity: 0%

None

[20] (U.S., 1975)

Exertional heatstroke

(n = 13)

Case series

Iced water immersion; target T_rect: 38.3°C

Cooling time; mortality; morbidity

Cooling time: < 60 minutes, 92.3%; cooling time: > 60 minutes, 7.7%; mortality: 0%; neurologic morbidity: 0%

None

[21] (U.S., 1979)

Exertional heatstroke

(n = 13)

Case series

Iced water immersion; target T_rect: 38.3°C to 38.8°C

Cooling time; mortality; morbidity

Cooling time (range): 10 to 40 minutes; myocardial ischemia: 7.7%; neurologic morbidity: 0%; mortality: 0%

None

[30] (U.S., 1996)

Exertional heatstroke

(n = 21)

Randomized controlled trial

Iced water immersion (1°C to 3°C) torso and upper legs (n = 14) versus wet towel and air exposure at 24.4°C (n = 7); target T_rect: 38.2°C to 40.1°C

Cooling rate

Conductive-based cooling faster than evaporative (0.20 ± 0.02 versus 0.11 ± 0.02°C/minute)

Small sample size; comparability of baseline characteristics undetermined; randomization method not specified; evaporative technique suboptimal